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67 Functional constipation and overweight 2 The highest prevalence of functional constipation was found in the Amazon region (19.4%), and the lowest prevalence was found in the Pacific region (7.5%). A diagnosis of functional constipation was made in 12.9% of normal-weight children, 13.1% of overweight children, and 14.9% of obese children and this difference was not statistically significant ( P = .73). Additional analyses comparing children with a BMI z-score >1 (overweight and obese children combined) with normal-weight children also did not reveal a significant difference between these two groups ( P = .66). In addition, 19 children had a BMI z-score ≥3; analysis revealed that functional constipation was not significantly more prevalent in this group (1/19 had functional constipation). Family factors such as being an only child, being the firstborn, or having divorced or separated parents were not associated with a significant difference in prevalence of functional constipation, overweight, or obesity. DISCUSSION This study was performed in Colombia, a developing country in South America. Unlike previous studies conducted in developed countries, we did not find an association between functional constipation and excessive bodyweight in children. The prevalence rates of functional constipation, overweight, and obesity found in this study are comparable with previous results from Colombia; Saps et al. 19 reported the prevalence of childhood functional constipation to be 14% in the Colombian city Pasto, and LeBlanc et al. reported that 23% of Colombian children are overweight or obese based on their BMI z-score according to the WHO cut-off values. 20 Our results regarding the association between functional constipation and overweight or obesity are also comparable with a population- based study by Costa et al. 21 , assessing the association between functional constipation and excessive bodyweight in 1,077 adolescents (10-18 years) in Brazil. They found a comparable prevalence of functional constipation in children with excessive bodyweight and children with normal weight (19.4% and 18.0%, respectively). The results of our study and the study performed by Costa et al. 21 differ from those of a population-based survey study that was conducted in the US, among 450 children (4-18 years of age). 3 This study demonstrated that functional constipation was significantly more prevalent in overweight and obese children (23%) than in normal-weight children (13.9%). This difference between two South American studies from developing countries and the study conducted in the US raises questions whether there is a difference between children with excessive bodyweight in South America compared with the US regarding their susceptibility to functional constipation. Genetics, lifestyle, diet, socioeconomic, and other factors may play an important role and a better understanding of these factors may help to explain these differences. In addition,